Metoprolol Succinate

Metoprolol is a beta-blocker that affects the heart and circulation (blood flow through arteries and veins).

Metoprolol is used to treat angina (chest pain) and hypertension (high blood pressure). It is also used to lower your risk of death or needing to be hospitalized for heart failure.

Metoprolol injection is used during the early phase of a heart attack to lower the risk of death.

Metoprolol may also be used for other purposes not listed in this medication guide.

You should not use this medicine if you are allergic to metoprolol, or other beta-blockers (atenolol, carvedilol, labetalol, nadolol, nebivolol, propranolol, sotalol, and others), or if you have:

• a serious heart problem such as heart block, sick sinus syndrome, or slow heart rate;
• severe circulation problems;
• severe heart failure (that required you to be in the hospital); or
• a history of slow heart beats that have caused you to faint.

Tell your doctor if you have ever had:

• asthma, chronic obstructive pulmonary disease (COPD), sleep apnea, or other breathing disorder;
• diabetes (taking metoprolol may make it harder for you to tell when you have low blood sugar);
• liver disease;
• congestive heart failure;
• problems with circulation (such as Raynaud's syndrome);
• a thyroid disorder; or
• pheochromocytoma (tumor of the adrenal gland).

Do not give this medicine to a child without medical advice.

Tell your doctor if you are pregnant or plan to become pregnant. It is not known whether metoprolol will harm an unborn baby. However, having high blood pressure during pregnancy may cause complications such as diabetes or eclampsia (dangerously high blood pressure that can lead to medical problems in both mother and baby). The benefit of treating hypertension may outweigh any risks to the baby.

Ask a doctor before using this medicine if you are breast-feeding. Metoprolol can pass into breast milk and may cause dry skin, dry mouth, diarrhea, constipation, or slow heartbeats in your baby.

Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose. Use the medicine exactly as directed.

Metoprolol should be taken with a meal or just after a meal.

Take the medicine at the same time each day.

Swallow the capsule whole and do not crush, chew, break, or open it.

A Toprol XL tablet can be divided in half if your doctor has told you to do so. Swallow the half-tablet whole, without chewing or crushing.

Measure liquid medicine carefully. Use the dosing syringe provided, or use a medicine dose-measuring device (not a kitchen spoon).

You will need frequent medical tests, and your blood pressure will need to be checked often.

If you need surgery, tell the surgeon ahead of time that you are using metoprolol.

You should not stop using metoprolol suddenly. Stopping suddenly may make your condition worse.

If you have high blood pressure, keep using this medicine even if you feel well. High blood pressure often has no symptoms. You may need to use metoprolol for the rest of your life.

Store at room temperature away from moisture and heat.

Metoprolol injection is given as an infusion into a vein. A healthcare provider will give you this injection in a medical setting where your heart and blood pressure can be monitored. Metoprolol injection*s are given for only a short time before switching you to the *oral form of this medicine.

Skip the missed dose and use your next dose at the regular time. Do not use two doses at one time.

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Avoid driving or hazardous activity until you know how this medicine will affect you. Your reactions could be impaired.

Drinking alcohol can increase certain side effects of metoprolol.

Get emergency medical help if you have signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

• very slow heartbeats;
• a light-headed feeling, like you might pass out;
• shortness of breath (even with mild exertion), swelling, rapid weight gain; or
• cold feeling in your hands and feet.

Common side effects may include:

• dizziness, tired feeling;
• depression, confusion, memory problems;
• nightmares, trouble sleeping;
• diarrhea; or
• mild itching or rash.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Tell your doctor about all your current medicines. Many drugs can affect metoprolol, especially:

• any other heart or blood pressure medications;
• epinephrine (Epi-Pen);
• an antidepressant;
• an ergot medicine--dihydroergotamine, ergonovine, ergotamine, methylergonovine; or
• an MAO inhibitor--isocarboxazid, linezolid, phenelzine, rasagiline, selegiline, tranylcypromine.

This list is not complete and many other drugs may affect metoprolol. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.

Your pharmacist can provide more information about metoprolol.